Childhood Hazard: Choking on Food Persists

About 34 children admitted to U.S. emergency rooms daily as experts urge greater public awareness

By Kathleen Doheny
HealthDay Reporter

MONDAY, July 29, 2013 (HealthDay News) -- About 34 children are treated in U.S. emergency rooms every day for choking on food, according to a new report, despite education campaigns and other prevention efforts.

"It's a very common thing," said researcher Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital, in Columbus, Ohio.

With his colleagues, he looked at a national database, comparing the numbers of choking injuries year by year. In 2001, about 10,400 U.S. children were treated in emergency departments for non-fatal choking on food. From 2001 through 2009, the annual estimate was about 12,400 children, aged 14 and under, Smith found.

The researchers tracked only non-fatal injuries, Smith said, because the database used does not provide adequate information on food-related choking deaths.

The average age of the children treated was 4.5 years old. The age group of children from newborns to 4 years old accounted for about 62 percent of the episodes.

Common foods involved were candy, meat, bone, fruits and vegetables. The new study appears online July 29 and in the August print issue of Pediatrics.

The study is thought to be the first nationally representative one to focus only on the non-fatal childhood food-related choking treated in U.S. emergency departments over a period of many years.

"We think much more attention needs to be paid to food choking," Smith said. He points to safeguards used for toys -- such as labeling toys for age-appropriateness and other education -- and says some of the same strategies can help reduce childhood food choking.

Among the strategies Smith proposes are food labeling, public education and redesign of certain foods. Food labels could warn parents of choking hazards for young children, much like toy labels do.

One example of food redesign that has made a difference, he said, is the redesign of the standard lollipop into a safety-type pop with a looped handle and other features.

Combining strategies always gives a better result, he said. "We know that labeling is one thing we can do, but we know from experience, from other public health [efforts], labeling is not effective as a standalone."

The study findings verify what emergency doctors already know, said Dr. Rodney Baker, director of the division of emergency medicine at Miami Children's Hospital. "There is this significant number of children who have to go to the ER because they choked on food," he said.

The list of common foods linked with choking found by Smith's team sounds somewhat familiar, Baker said. He said he also often treats children who have choked on nuts and sometimes need to have a procedure called bronchoscopy to remove the inhaled food from the airways.

What is needed to reduce childhood food choking, Baker said, is "more training, more teaching, more awareness." Some of the choking incidents are hard to prevent, he said, but parents can take simple precautions. For instance, "If you are giving your kids a hot dog, cut it lengthwise," he said. That will eliminate the cylindrical shape that can be hazardous when eaten by young children.

Parents and grandparents like to give children finger foods, Baker said, as they are convenient and easy for the kids to eat. However, he suggested they take precautions and avoid foods that are easy to choke on, such as grapes and nuts.

Smith said that parents and other caretakers could also take a first aid or CPR class that includes instruction in how to handle a choking victim.

More information

To learn more about choking prevention in children, visit the Childhood Injury Prevention Alliance (http://childinjurypreventionalliance.org/ChokingPreventionFactSheet.aspx ).

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.